Bladder augmentation

Abstract

The goal of bladder augmentation is to protect the upper urinary tract when less-invasive procedures are ineffective and to extend dry periods in children in whom incontinence is associated with low bladder compliance and capacity. There is no segment of the gastrointestinal tract (GIT) that is ideal for bladder augmentation, and stomach, ileum, and sigmoid colon have been used. Each segment has distinct advantages and disadvantages. Bladder auto-augmentation, which involves dissection of the seromuscular layers of the bladder, has been considered as an alternative to using segments of the GIT, to avoid disadvantages. There are two types of cystoplasty, namely, augmentation cystoplasty in which the bladder is enlarged and substitution cystoplasty in which the bladder is replaced. The method of choice depends on the state of the bladder. The main complications of bladder augmentation are infection, stone formation, metabolic complications, perforation, and cancer. Careful postoperative follow-up is crucial. It is particularly important to pay closer attention to patients, who are more than 10 years postoperative as they are at a relatively high risk for developing bladder cancer.